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Myelomenignocele Case Study

I need help with this case study. Please answering the following (6) questions in own words, and as much information as possible, if you use references please include. Thank you. Your help is greatly needed.

Case Study:

Melissa is an 8-year-old girl with a diagnosis of myelomenigocele.

Melissa's mother had a difficult pregnancy. The baby was born by vaginal delivery and surgical closure of the back was performed immediately A CT scan confirmed a diagnosis of hydrocephalus and a ventriculoperitoneal shunt was indicated.

Melissa has a neurogenic bladder with recurring urinary tract infections. She has partial paralysis of the lower extremities, but she can ambulate with short leg braces and forearm crutches. At times, she prefers to use a wheelchair. Her mother reports that Melissa has difficulty with the short leg braces due to flexion contractures of the knees. Melissa is bright and enjoys school. However, she often feels "left out and alone"

1. Describe the potential SECONDARY complications associated with myelomenignocele.

2. Explain the difference between spina bifida occulta and spina bifida cystica.

3. Identify and explain the types of medical and surgical procedures that may be involved throughout Melissa's childhood.

4. What is the prognosis for this diagnosis?

5. Address the role of a medical professional during a 20 year time period, starting at age 3. Example, physical therapist.

6. Analyze and discuss the impact of this type of disability on a person's quality of life. Discuss the implications for family members.

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RESPONSE:

1. Describe the potential SECONDARY complications associated with myelomenignocele.

Spina bifida is a serious birth abnormality in which the spinal cord is malformed and lacks its usual protective skeletal and soft tissue coverings.

According to the American Academy of Pediatrics, for example, children with higher openings on the back have more difficulties secondary problems including:

? Hydrocephalus: Children with myelomenigocele may have blockage of the normal routes of drainage of the cerebrospinal fluid (the fluid that surrounds the brain and spinal cord). About ¾ of children with myelomenigocele need a special tube (shunt) placed between the brain and some other part of the body to help drain off the fluid. These shunts may become blocked or infected. If the child has a fever, or begins to vomit, act very sleepy or irritable, notify the parents immediately.

? Orthopedic (Bone) Problems: Children with spina bifida may have problems with their feet which require casts. Many children with spina bifida cannot move muscles in their legs. Some children with spina bifida can walk with the use of special equipment. If they injure their legs, they might not be able to feel it. Special care must be given to the skin when an injury or skin breakdown occurs.
? Urinary Problems: A child with spina bifida may have a flaccid (loose, floppy) bladder or a spastic (poorly coordinated) bladder. Many hildren with spina bifida need their bladders emptied with a catheter. The use of a catheter helps the child empty his/her bladder, which prevents bladder infection and prevents the kidneys from being damaged. If the child's urine looks cloudy or smells bad, it may be a sign of infection and the parent should be notified.

? Bowel Problems: Some children with spina bidifa cannot be toilet trained because they cannot control the muscles to the rectum. Most can learn control. Preventing constipation and a diet high in fiber can help. Check with the family or the child's doctor for individual recommendations.

? Intelligence: About 2/3 of children with spina bifida have normal intelligence. About ¾ of children with spina bifida attend regular school. Attending a regular school is important to help these children develop socially and emotionally. Each child with spina bifida is different. The parent can help by describing his/her individual needs. All these children should be encouraged to do as much as they can by themselves, as they can lead very productive lives (http://74.125.45.104/search?q=cache:O46YhTvB_0wJ:www.ecels-healthychildcarepa.org/content/FS-Spina%2520Bifida.pdf+myelomenigocele&hl=en&ct=clnk&cd=4&gl=ca&client=firefox-a).

Other secondary problems:

? Allergy to Latex. According to the Spina Bifida Association of America (SBAA), over 73 percent of people with spina bifida develop an allergy to latex, ranging from mild to life-threatening. The common use of latex in medical facilities makes this a particularly serious concern. The most common approach is to try to avoid development of the allergy by avoiding contact with latex containing products such as examination gloves, catheters, and many of the products used by dentists ...

Solution Summary

This solution addressed six questions related to the case study on Myelomenignocele.

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